Communicable Diseases Surveillance - Additional reports

This report published in Communicable Diseases Intelligence Volume 23, No 1, 21 January 1999 contains quarterly surveillance reports.

Page last updated: 22 February 1999

A print friendly PDF version is available from this Communicable Diseases Intelligence issue's table of contents.


Serious Adverse Events Following Vaccination Surveillance Scheme

The Serious Adverse Events Following Vaccination Surveillance Scheme is a national surveillance scheme which monitors the serious adverse events that occur rarely following vaccination. More details of the scheme were published in Commun Dis Intell 1997:21;8.

Acceptance of a report does not imply a causal relationship between administration of the vaccine and the medical outcome, or that the report has been verified as to the accuracy of its contents.

It is estimated that 250,000 doses of vaccines are administered every month to Australian children under the age of six years.

Results for the reporting period 2 September 1998 to 31 January 1999.

There were 320 reports of serious adverse events following vaccination for this reporting period (Table 6). Onset dates were from 1995 to 1998, the majority (92%) being in 1998. Reports were received from Australian Capital Territory (25), New South Wales (38), Northern Territory (9), Queensland (63), South Australia (11), Victoria (43) and Western Australia (131). No reports were received from Tasmania for this period. The majority of reports received from Western Australia were from 1998 (88%).

The most frequently reported events following vaccination were persistent screaming (170 cases, 53%), followed by other reactions (56 cases, 17.5%), temperature of 40.5o C or more (34 cases, 10.6%) and hypotonic/hyporesponsive episodes (38 cases, 11.9%). One death within 30 days of immunisation was reported from Victoria. The cause of death was unclear according to the coroner's report.

Of the 38 reactions associated with MMR vaccine, 37 were since August 1998 when the measles immunisation campaign was initiated. The reports associated with the measles campaign will be published in CDI at a later date.

Forty of the 320 cases were hospitalised. There were 6 cases that had not recovered at the time of reporting while 303 cases had recovered. There was incomplete information on follow-up on 11 cases.

Two hundred and fifty (78%) cases were associated with Diphtheria-Tetanus-Pertussis (DTP), vaccine either alone or in combination with other vaccines. Of these, 60 per cent of reports were associated with the first dose of DTP and 28 per cent with the second dose.

Table 6. Adverse events following vaccination reported in the period 2 September 1998 to 31 January 1999

Event
Vaccines Reporting States or Territories2 Total reports for this period2
DTP DTP/ Hib DTP/ OPV/ Hib DTP /OPV/ MMR DTP/ OPV DTP/ OPV/ Hib/ Hep B MMR Hep B Other1
Persistent screaming
82
2
73
2
4
6
ACT, NSW, Qld, Vic, WA
170
Hypotonic/hyporesponsive episode
10
2
21
2
1
1
1
ACT, NSW, Qld, Vic, WA
38
Temperature of 40.5EC or more
26
5
1
2
ACT, Qld, WA
34
Convulsions
1
1
3
4
2
ACT, NSW, Qld, SA, Vic, WA
12
Anaphylaxis
1
3
NSW, NT
4
Shock
1
1
NT, Vic
2
Death
1
Vic
1
Other
3
2
6
2
27
6
7
ACT, NSW, NT, Qld, SA, Vic, WA
56
Not stated
Total
122
7
110
2
2
7
38
8
16
3173

1. Includes influenza, DTPa, CDT, OPV, Hepatitis B, pneumococcal, BCG and ADT vaccines and rabies immunoglobulin (HRIG).
2. Includes 1 event for each of the following vaccines: Hib/other (convulsions), OPV/Hib (persistent screaming), Hib, Hep/other, OPV (other).
3. Three cases have missing events


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HIV and AIDS Surveillance

National surveillance for HIV disease is coordinated by the National Centre in HIV Epidemiology and Clinical Research (NCHECR), in collaboration with State and Territory health authorities and the Commonwealth of Australia. Cases of HIV infection are notified to the National HIV Database on the first occasion of diagnosis in Australia, by either the diagnosing laboratory (ACT, New South Wales, Tasmania, Victoria) or by a combination of laboratory and doctor sources (Northern Territory, Queensland, South Australia, Western Australia). Cases of AIDS are notified through the State and Territory health authorities to the National AIDS Registry. Diagnoses of both HIV infection and AIDS are notified with the person's date of birth and name code, to minimise duplicate notifications while maintaining confidentiality.

Tabulations of diagnoses of HIV infection and AIDS are based on data available three months after the end of the reporting interval indicated, to allow for reporting delay and to incorporate newly available information. More detailed information on diagnoses of HIV infection and AIDS is published in the quarterly Australian HIV Surveillance Report, available from the National Centre in HIV Epidemiology and Clinical Research, 376 Victoria Street, Darlinghurst NSW 2010. Telephone: (02) 9332 4648 Facsimile: (02) 9332 1837.

HIV and AIDS diagnoses and deaths following AIDS reported for 1 to 31 August 1998, as reported to 30 November 1998, are included in this issue of Commun Dis Intell (Tables 7 and 8).

Table 7. New diagnoses of HIV infection, new diagnoses of AIDS and deaths following AIDS occurring in the period 1 to 31 August 1998, by sex and State or Territory of diagnosis

  State or territory Totals for Australia
ACT NSW NT Qld SA Tas Vic WA This period 1998 This period 1997 Year to date 1998 Year to date 1997
HIV diagnoses Female
0
4
0
1
0
0
2
1
8
6
60
46
  Male
0
25
1
2
0
0
13
2
43
52
425
483
  Sex not reported
0
0
0
0
0
0
0
0
0
0
6
11
  Total1
0
29
1
3
0
0
15
3
51
58
491
541
AIDS diagnoses Female
0
0
0
0
0
0
0
0
0
1
7
20
  Male
0
4
0
2
0
0
3
0
9
31
120
217
  Total1
0
4
0
2
0
0
3
0
9
32
127
237
AIDS deaths Female
0
0
0
1
0
0
0
0
1
0
6
9
  Male
0
2
0
0
1
0
3
0
6
19
64
160
  Total1
0
2
0
1
1
0
3
0
7
19
70
170


Table 8. Cumulative diagnoses of HIV infection, AIDS and deaths following AIDS since the introduction of HIV antibody testing to 31 August 1998, by sex and State or Territory

  ACT NSW NT Qld SA Tas Vic WA Australia
HIV diagnoses Female
22
563
7
131
54
4
197
95
1,073
  Male
183
10,396
99
1,841
637
77
3,699
866
17,798
  Sex not reported
0
259
0
0
0
0
24
0
283
  Total1
205
11,237
106
1,978
691
81
3,933
964
19,195
AIDS diagnoses Female
8
160
0
45
20
2
64
23
322
  Male
82
4,392
32
768
323
41
1,554
337
7,529
  Total1
90
4,563
32
815
343
43
1,625
362
7,873
AIDS deaths Female
2
113
0
29
15
2
46
16
223
  Male
62
3,063
23
533
220
27
1,216
241
5,385
  Total1
64
3,183
23
564
235
29
1,268
258
5,624

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Childhood immunisation coverage

Tables 9 and 10 provide the latest quarterly report on childhood immunisation coverage from the Australian Childhood Immunisation Register (ACIR).

The data show the percentage of children fully immunised at age 12 months for the cohort born between 1 July and 30 September 1997 and at 24 months of age for the cohort born between 1 July and 30 September 1996, according to the Australian Standard Vaccination Schedule (Tables 9 and 10).

A full description of the methodology used can be found in Commun Dis Intell 1998;22:36-37.

Table 9. Percentage of children immunised at 1 year of age, preliminary results by disease and State for the birth cohort 1 July to 30 September 1997; assessment date 30 September 1998

Vaccine
State or Territory Australia
ACT NSW NT Qld SA Tas Vic WA
Total number of children
1,055
22,820
889
12,522
4,771
1,610
15,738
6,438
65,843
DTP (%)
89.1
84.5
80.1
88.3
87.5
85.8
86.9
85.4
86.1
OPV (%)
89.5
84.2
79.3
87.2
87.6
86.1
87.1
85.4
85.9
Hib (%)
89.0
83.8
83.2
88.6
87.5
85.8
86.8
85.4
86.0
Fully Immunised (%)
88.6
82.5
75.3
85.9
86.6
85.1
86.0
84.3
84.5
Change in fully immunised since last quarter (%)
+3.6
+0.2
-0.7
+0.1
+1.3
-1.1
-0.2
+1.1
+0.2


Table 10. Proportion of children immunised at 2 years of age, preliminary results by disease and State for the birth cohort 1 July to 30 September 1996; assessment date 30 September 1998

Vaccine
State or Territory Australia
ACT NSW NT1 Qld SA Tas Vic WA
Total number of children
1,135
22,836
929
12,623
4,864
1,753
15,987
6,624
66,751
DTP (%)
82.2
79.3
66.3
84.0
80.6
78.7
80.4
77.6
80.2
OPV (%)
87.4
83.3
77.1
89.1
85.7
85.9
86.6
79.1
85.0
Hib (%)
80.4
79.4
71.6
84.0
80.8
79.2
80.7
77.9
80.4
MMR (%)
85.9
83.0
77.4
89.5
83.9
84.8
86.9
80.6
85.0
Fully Immunised (%)2
75.4
66.8
54.8
75.9
67.2
67.7
70.0
61.6
68.8
Change in fully immunised since last quarter (%)
+5.7
+3.0
+4.1
+3.1
+1.6
+0.7
+2.3
+2.4
+2.7

1. The 12 months age data for this cohort was published in Commun Dis Intell 1998;22:123.
2. These data relating to 2 year old children should be considered as preliminary. The proportions shown as 'fully immunised' appear low when compared with the proportions for individual vaccines. This is at least partly due to poor identification of children on immunisation encounter forms.
Acknowledgement: These figures were provided by the Health Insurance Commission (HIC), to specifications provided by the Commonwealth Department of Health and Aged Care. For further information on these figures or data on the Australian Childhood Immunisation Register please contact the Immunisation Section of the HIC: Telephone 02 6203 6185.


Sentinel Chicken Surveillance Programme

Sentinel chicken flocks are used to monitor flavivirus activity in Australia. The main viruses of concern are Murray Valley encephalitis (MVE) and Kunjin which cause the potentially fatal disease Australian encephalitis in humans. Currently 26 flocks are maintained in the north of Western Australia, seven in the Northern Territory, nine in New South Wales and ten in Victoria. The flocks in Western Australia and the Northern Territory are tested year round but those in New South Wales and Victoria are tested only from November to March, during the main risk season.

Results are coordinated by the Arbovirus Laboratory in Perth and reported bimonthly. For more information see Commun Dis Intell 1998;22:7

AK Broom,1 J Azoulas,2 JS Mackenzie,3 L Melville,4 DW Smith5 and PI Whelan6

1. Department of Microbiology, The University of Western Australia
2. Veterinary Research Institute, Victoria
3. Department of Microbiology, The University of Queensland
4. Berrimah Agricultural Research Centre, Northern Territory
5. PathCentre, Western Australia
6. Department of Health and Community Services, Northern Territory



November/December 1998

Sentinel chicken serology was carried out for 24 of the 27 flocks in Western Australia in November and December 1998. There were no seroconversions to flaviviruses recorded during this period.

Serum samples from 5 of the 7 Northern Territory sentinel chicken flocks were tested in our laboratory in October and November 1998. Samples from four flocks were tested in December 1998. There were no seroconversions to flaviviruses recorded during this period.

The sentinel chicken programme in Victoria commenced at the beginning of November 1998. There were no seroconversions to flaviviruses recorded in November or December 1998.

* Details of the locations of all chicken flocks are given in Commun Dis Intell 1998;22:7-8.


This article was published in Communicable Diseases Intelligence Volume 23, No 1, 21 January 1999.

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This issue - Vol 23, No 1, 21 January 1999